2015 Application Form

Application Deadline: Tuesday, March 31, 2015 11:59PM ET

Form Login Account (optional)

Creating an account enables you to return to this form and your submitted results. An account will also enable you to partially complete this form and return later to finish the form. The account you establish is only for this form.

Instructions

The application requires general applicant information as well as the following six (6) requirements. Attachments must be added to the online application in the specified places as PDF files.

Include your name on all documents. In the case of the recommendation letter, an option is available for the faculty person to submit the recommendation to APTR directly by emailing it to pasp@aptrweb.org.

1.Applicant Curriculum Vitae or Resume

2. Transcript for certifying program enrollment

3.One (1) Letter of Recommendation from a faculty member or your mentor

4. Letter of Commitment from your project mentor

5. Statement of Interest essay

6. Project Proposal

Please Note: In order to properly submit your application you must click "submit" at the end of the application from.

Applicant Eligibility

Applicant must be a current student in one of the following areas of graduate study within the US:

Allopathic Medicine: Entering Years 2-4 in Fall 2015

Dentistry: Entering Years 2-4 in Fall 2015

Graduate Nursing

Graduate Physician Assistant

Osteopathic Medicine: Entering years 2-4 in Fall 2015

Pharmacy: Entering year 3 or 4 of professional pharmacy program in Fall 2015

Please Note: Applicants graduating in 2015 are not eligible for the program. Only candidates who can commit to attending each symposium day in full (June 26-28, 2015 in Washington, DC) at the applicable registration fee rate should apply.

By checking the boxes below you are agreeing to the following:

I meet the academic eligibility requirements

I am able to attend the Symposium in its entirety and pay the applicable student registration fee

I will implement and complete the post-Symposium project plan

Failure to comply to the above statements will result in ineligibility.